| NPI | 1720572456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERIBERTO LUIS RIVERA Co Owner 407-288-3371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL 48-641825503) |
| Enumeration Date | 2018-06-16 |
| Last Update Date | 2022-09-09 |